Successful Remission of Refractory Plantar Warts with Cantharidin Plus in an Immunosuppressed Patient

Organ transplant patients on immunosuppressive therapies are susceptible to developing refractory human papillomavirus (HPV) infections including cutaneous warts. These warts are known to respond to conservative treatment modalities in the immunocompetent but are often refractory to multiple treatments in the immunosuppressed. Here we report a case of an immunosuppressed adult with plantar warts recalcitrant to numerous therapies that was ultimately treated successfully with cantharidin-podophyllotoxin-salicylic acid (CPS) monotherapy. After 19 treatment sessions over a 16-month time period, complete resolution was achieved. CPS may be a promising treatment modality in cases of severe, refractory verruca plantaris such as those seen in our immunosuppressed patient.